Preference for and Efficacy of a PrEP Decision Aid for Women with Substance Use Disorders
| Autor: | Carolina Price, Glyn Elwyn, Yue Song, Laurel Sharpless, Jaimie P. Meyer, Lynn M. Madden, Frederick L. Altice, DeShana Tracey |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Population Human immunodeficiency virus (HIV) Medicine (miscellaneous) Hiv risk medicine.disease_cause Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Primary outcome All institutes and research themes of the Radboud University Medical Center Extant taxon medicine education Pharmacology Toxicology and Pharmaceutics (miscellaneous) Original Research education.field_of_study business.industry Health Policy Opioid use disorder medicine.disease Preference PrEP Patient Preference and Adherence substance use disorders decision aids Family medicine women Substance use business Social Sciences (miscellaneous) |
| Zdroj: | Patient preference and adherence Patient Preference and Adherence, 15, pp. 1913-1927 Patient Preference and Adherence, 15, 1913-1927 |
| ISSN: | 1177-889X |
| Popis: | Jaimie Meyer,1,2 Carolina Price,1 DeShana Tracey,1 Laurel Sharpless,2 Yue Song,2,3 Lynn Madden,1,4 Glyn Elwyn,5â 7 Frederick Altice1,2,4,8 1Yale School of Medicine, AIDS Program, New Haven, CT, USA; 2Yale School of Public Health, New Haven, CT, USA; 3Oregon Health Sciences University, Portland, OR, USA; 4APT Foundation, Inc., New Haven, CT, USA; 5The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH, USA; 6Scientific Institute for Quality of Healthcare, University Nijmegen Medical Centre, Nijmegen, Netherlands; 7Cochrane Institute for Primary Care and Public Health, Cardiff University, Cardiff, UK; 8Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, MalaysiaCorrespondence: Jaimie MeyerYale School of Medicine, AIDS Program, 135 College Street, Suite 323, New Haven, CT, 06510, USATel +203 737 6233Fax +203 737 4051Email jaimie.meyer@yale.eduBackground: Women with substance use disorders (SUDs) are a key population for HIV prevention with pre-exposure prophylaxis (PrEP), though uptake is limited by awareness of PrEP, misestimation of personal HIV risk, and minimally integrated HIV prevention and addiction treatment services. Patient-centered decision aids (DA) could address these barriers to PrEP, but no extant DA for PrEP has been published, including for women with SUDs.Methods: We developed a patient-centered PrEP DA for women in addiction treatment. In a pilot randomized preference trial, we compared the DA to enhanced standard of care (eSOC) providing standardized information. The primary outcome was opting to receive more information through the DA; we also assessed the impact of the DA on PrEP decisional preference and PrEP uptake over 12 months.Results: A total of 164 enrolled participants (DA: 83; eSOC: 81) were similar in terms of HIV risk and demographics, which are representative of women in addiction treatment programs nationally, and most (92%) had opioid use disorder. Half of participants were PrEP eligible, though 37% underestimated their personal HIV risk. Independent correlates of selecting the PrEP DA relative to eSOC included higher alcohol use severity (aOR 4.13, 95% CI 1.05â 16.28, p=0.04) and perception of high risk for HIV (aOR 2.95, 95% CI 1.19â 7.35, p=0.02). For those selecting the DA, interest in PrEP increased significantly from 25% to 89%. DA participants were also significantly more likely than eSOC participants to see a provider for PrEP during follow-up (15.7% vs 6.2%; p=0.05).Conclusion: Half of the women selected to use the DA, and those who did significantly increased their engagement in the HIV prevention cascade through increased interest in and initiation of PrEP. Future iterations should accelerate the HIV prevention cascade for women with SUDs by integrating PrEP decision aids into existing addiction treatment services and actively linking women to PrEP.Keywords: PrEP, women, substance use disorders, decision aids |
| Databáze: | OpenAIRE |
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